We welcome the opportunity to respond to the concerns of Dr Wise1 from the American Chemistry Council, regarding our report on the association between childhood infections and use of bleach at home.2
Dr Wise expresses disappointment with 'design flaws' and 'the speculative nature of our conclusions'. We do not agree that our study was badly designed, and the limitations have been carefully considered and discussed in our original paper. We relied on questionnaires for both exposure and outcome, but this does not imply flawed results or bad study design. Obviously, future studies are needed with better exposure and outcome assessment to further address the causal nature of the associations, as we acknowledge in the discussion.
Dr Wise is particularly concerned about the reliability of self-reported illnesses. Indeed, no further description of the targeted infections was given to the parents, nor were these illnesses confirmed by medical diagnosis. The...
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